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Monday, 18 February 2008
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Women's Health: Birth Control Facts
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Abortion

A drug called mifepristone (also known as RU-486) can block a hormone called progesterone that is needed for pregnancy to continue, if an egg has been fertilized and implanted in your uterus. By taking this drug (and another one called misoprostol), a pregnancy can end if it has been 49 days or fewer since your last menstrual period.

These drugs are given only by a doctor and only by certain doctors who are trained to diagnose problems that may develop such as ectopic pregnancy. You will be asked to sign a statement indicating you understand you are ending a pregnancy.

Once you take on oral dose (pill taken by mouth) of mifepristone, you will be given misoprostol 2 days later to cause your uterus to contract and expel the embryo through the vagina.

You will experience cramping and bleeding, and you must return to your doctor a few times for examination. 
 
This method is not a preventive form of birth control.

 


Future Methods

Although development of new birth control methods in the United States has slowed in the past few years, research outside of the United States continues at a rapid pace. Many new birth control designs are being tested to provide a greater variety of methods with fewer side effects and that are safer and are more effective.  

  • Pill for men: One exciting new development is a hormonal contraceptive method for men. The male birth control pill manipulates steroid hormones to decrease sperm development.

  • Injection for men: A reversible male birth control method, injections of progestin every 3 months suppressed sperm production in an Australian study. Because this hormone reduces a man's sex drive, implants were placed under the men's skin every 4 months.

  • Implants: Newer methods of implants that go under the skin are on the horizon. 

    • Implanon is a single-rod implant that is 4 cm long and 2 mm in diameter. Its more potent hormones would stop ovulation (release of an egg) in women. The implant is expected to last 3 years. In studies, so far no pregnancies have happened while women were testing this implant. It is not yet approved for use. 
    • Another implant (known as Uniplant) is being tested. It would work in place for as long as 1 year.

    • A biodegradable implant, Capnor, is being tested. Because it dissolves, there is no need to remove it. Birth control protection would last for 1 year. 

    • Biodegradable pellet implants are currently undergoing testing. They dissolve within 2 years. Insertion of the pellets has been demonstrated to be simple; however, if the woman wishes for removal several months later, removal has been noted to be difficult.  

  • Diaphragm: Lea's Shield is a 1-size-fits-all device like a diaphragm. It will soon be available in the United States. This device consists of a 1-way valve that allows air to escape during placement, thus creating a suction effect against the cervix. Fluids can flow in one direction, out of the vagina, so uterine and cervical fluids can be released into the vaginal canal, but sperm cannot enter.  

  • Tubal ligation, new methods: A few potential methods of tubal sterilization are under investigation. One of these new developments includes chemical scarring of the fallopian tubes. The scarring is a result of a combination of phenol and a thickening agent and phenol quinacrine that ultimately leads to blockage of the tubes. Another nonsurgical form of tubal sterilization uses chemical plugs. Approved for use in Canada, the gluelike substance is placed into the fallopian tube. A reversible chemical plug also can be created by the injection of silicone into the fallopian tubes. The silicone eventually hardens but can be removed later. Chemical scarring and plugs are being tested as potential methods of vasectomy as well.  

  • Vaccine: A pregnancy vaccine is one of the most controversial and exciting forms of birth control under development. The pregnancy vaccine stimulates an immune response against sperm so that fertilization does not occur.



VitaDocs Medical Reference from eMedicineHealth

 


Authors and Editors

Author: Omnia M Samra, MD, Clinical Instructor, Department of Obstetrics and Gynecology, Medical College of Pennsylvania/Hahnemann University.

Editors: Bryan D Cowan, MD, Director, Division of Reproductive Endocrinology, Professor, Department of Obstetrics and Gynecology, University of Mississippi College of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Lee P Shulman, MD, Professor of Obstetrics and Gynecology, Head, Section of Reproductive Genetics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.



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